<!DOCTYPE html>
<html>
<head>
	<meta charset="UTF-8">
	<title>病案首页</title>
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</head>
<body>
<div>
    <div class="showstyle">
        <a id="showtext" onclick="showdiv_a('contentid','showtext')">基本信息</a>
       <!-- <div class="baset-topbtn">
            <button class="babtn babtn-save" onclick="baseInfo();">保存</button>
        </div>-->
    </div>
    <div class="none" id="contentid">
        <div class="page-allinfo">
        <div class="clearfix padding10" style="width:auto;">
            <form id="baseInfo">
                <input type="hidden" name="id" id="baseInfoId">
            <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                <tr>
                    <td class="width_7">姓名：</td>
                    <td><span ><input  class="easyui-validatebox inpborder" name="name" style="width:180px;"></span></td>
                    <td class="width_4">性别：</td>
                    <Td >
                        <input  class="easyui-validatebox inpborder" name="sex" id="sexId" style="width:150px;"></td>
                    <Td class="width_4">年龄：</td>
                    <td><span ><input  class="easyui-validatebox inpborder" name="age"></span></td>
                    <td class="width_4">出生日期：</td>
                    <td><span ><input  class="easyui-datebox inpborder" name="dateOfBirth"></span></td>

                    <td class="width_lasttd"></td>
                </tr>
            </table>
           <!-- <table cellspacing="0" cellpadding="0" border="0" width="98%" class="baind-tab">
                <tr>
                    <td class="width_7" align="center">（年龄不足1周岁的）年龄：</td>
                    <td><span><input  class="easyui-validatebox inpborder"/></span></td>
                    <td class="width_6">新生儿出生体重：</td>
                    <td><span><input  class="easyui-validatebox inpborder" style="width:40px"/>克</span></td>
                    <td class="width_6">新生儿入院体重：</td>
                    <td><span><input  class="easyui-validatebox inpborder" style="width:40px"/>克</span></td>
                    <td class="width_lasttd"></td>
                </tr>
            </table>-->
            <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                <tr>

                    <td class="width_7">籍贯：</td>
                    <td><span  ><input  name="nativePlace" class="easyui-validatebox inpborder" style="width:180px;"/></span></td>

                    <td class="width_4">民族：</td>
                    <td><span ><input  name="nation" id="nation" class="easyui-combobox inpborder" id="nation"/></span></td>
                    <td class="width_4" >职业：</td>
                    <td><span  ><input  name="occupation"  id="occupation" class="easyui-combobox inpborder" /></span></td>
                    <td class="width_4" >婚姻：</td>
                    <td><span>
                        <input  name="maritalStatus"  id="maritalStatus" class="easyui-combobox inpborder" />
										</span>
                    </td>
                    <td class="width_lasttd"></td>
                </tr>
            </table>
            <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                <tr>
                    <td class="width_7">出生地：</td>
                    <td><span ><input  name="birthPlace" class="easyui-validatebox inpborder"style="width:180px;" /></span></td>
                    <td class="width_4">身份证号：</td>
                    <td><span><input  name="idNo"  class="easyui-validatebox inpborder" style="width:150px"/></span></td>
                    <td class="width_4">户口地址：</td>
                    <td><span><input  class="easyui-validatebox inpborder" name="mailingAddress"></span></td>
                    <td class="width_4">邮政编码：</td>
                    <td><span><input  class="easyui-validatebox inpborder" name="zipCode"></span></td>
                    <td class="width_lasttd"></td>
                </tr>
            </table>
            <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                <tr>
                    <td class="width_7">工作单位及地址：</td>
                    <td><span  ><input  class="easyui-validatebox inpborder" name="zipCode" style="width:180px;"></span></td>
                    <td class="width_4">单位电话：</td>
                    <td><span  style="width: 200px;"><input  name="phoneNumberBusiness" class="easyui-validatebox inpborder"></span></td>
                    <td class="width_4">邮政编码：</td>
                    <td><input  name="phoneNumberBusiness" class="easyui-validatebox inpborder"></span></td>
                    <td class="width_4"> 国籍：</td>
                    <td><span style="width:100px;"><input  name="citizenship" id="citizenship" class="easyui-combobox inpborder"></span></td>
                    <td class="width_lasttd"></td>
                </tr>
            </table>
            <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                <tr>
                    <td class="width_7">联系人姓名：</td>
                    <td><span ><input  name="nextOfKin" class="easyui-validatebox inpborder" style="width:180px;"></span></td>
                    <td class="width_4">关系：</td>
                    <td><span  style="width: 100px"><input  name="relationship" id="relationship" class="easyui-combobox inpborder"></span></td>
                    <td class="width_4">地址：</td>
                    <td><span  style="width:220px;"><input  name="nextOfKinAddr" class="easyui-validatebox inpborder"></span></td>
                    <td class="width_4">电话：</td>
                    <td><span  style="width: 120px"><input  name="nextOfKinPhone" class="easyui-validatebox inpborder"></span></td>
                    <td class="width_lasttd"></td>
                </tr>
            </table>
            </form>
        </div>
            </div>
    </div>
    <div class="showstyle">
        <a id="showtext1" onclick="showdiv_a('contentid1','showtext1')">入(出)院信息</a>
      <!--  <div class="baset-topbtn">
            <button class="babtn babtn-save">保存</button>
        </div>-->
    </div>
    <div class="none" id="contentid1">
        <div class="page-allinfo">
            <div class="clearfix padding10" style="width:auto;">
            <form id="inHosInfo" method="post">
                <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                    <tr>
                        <td class="width_4">入院途径：</td>
                        <td><span><input  name="fromOtherPlaceIndicator" id="fromOtherPlaceIndicator" class="easyui-combobox inpborder"></span></td>
                        <td class="width_4">入院时间：</td>
                        <td><span ><input  name="admissionDateTime" class="easyui-datebox inpborder"></span></td>
                        <td class="width_4">入院科别：</td>
                        <td><span style="width:100px;"><input  name="deptAdmissionTo" id="dept" class="easyui-combobox inpborder"></span></td>
                        <td class="width_2">病房：</td>
                        <td><span style="width:100px"><input name="adtRoomNo" class="easyui-validatebox inpborder"></span></td>
                        <td class="width_4">转科科别：</td>
                        <td><span  style="width: 100px"><input  class="easyui-validatebox inpborder"></span></td>
                        <td class="width_lasttd"></td>
                    </tr>
                </table>
                <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                    <tr>
                        <td class="width_4">出院时间：</td>
                        <td><span  style="width:200px"><input  name="dischargeDateTime" class="easyui-datebox inpborder"></span></td>
                        <td class="width_4">出院科别：</td>
                        <td><span style="width:100px"><input  name="deptDischargeFrom" id="deptDisFrom" class="easyui-combobox inpborder"></span></td>
                        <td class="width_2">病房：</td>
                        <td><span  style="width:100px"><input name="ddtRoomNo" class="easyui-validatebox inpborder"></span></td>
                        <td class="width_4">实际住院：</td>
                        <td><span><input  class="easyui-validatebox inpborder" />天</span></td>
                        <td class="width_lasttd"></td>
                    </tr>
                </table>
                <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                    <tr>
                        <td class="width_5">门(急)诊诊断：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name=""></span></td>
                        <td class="width_4">疾病编码：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                        <td class="width_lasttd"></td>
                    </tr>
                </table>
            </form>
                </div>
        </div>
    </div>
    <div class="showstyle">
        <a id="diagnosis" onclick="showdiv_a('diagnosisInfo','diagnosis')">诊断</a>
      <!--  <div class="baset-topbtn">
            <button class="babtn babtn-save">保存</button>
        </div>-->
    </div>
    <div class="none" id="diagnosisInfo">
        <div class="page-allinfo">
            <div class="clearfix padding10" style="width:auto;">
               <table  width="100%"   cellspacing="0" cellpadding="0">
                   <thead>
                   <tr>
                       <td>出院诊断</td>
                       <td>疾病编码</td>
                       <td>入院病情</td>
                       <td>出院诊断</td>
                       <td>疾病编码</td>
                       <td>入院病情</td>
                   <tr/>
                   </thead>
                   <tbody>
                   <tr>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                   </tr>
                   <tr>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                   </tr>
                   <tr>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                   </tr>
                   <tr>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                   </tr>
                   <tr>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                       <td>----</td>
                   </tr>
                   </tbody>
               </table>
            </div>
         </div>
    </div>
    <div class="showstyle">
        <a id="operation" onclick="showdiv_a('operationInfo','operation')">手术</a>
    <!--    <div class="baset-topbtn">
            <button class="babtn babtn-save">保存</button>
        </div>-->
    </div>
    <div class="none" id="operationInfo">
        <div class="page-allinfo">
            <div class="clearfix padding10" style="width:auto;">
                <table  width="100%"   cellspacing="0" cellpadding="0">
                    <thead>
                    <tr>
                        <td>手术及操作编码</td>
                        <td>手术及操作日期</td>
                        <td>手术级别</td>
                        <td>手术及操作名称</td>
                        <td>手术及操作医师</td>
                        <td>切口愈合等级</td>
                        <td>麻醉方式</td>
                        <td>麻醉医师</td>
                    <tr/>
                    </thead>
                    <tbody>
                    <tr>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                    </tr>
                    <tr>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                    </tr>
                    <tr>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                    </tr>
                    <tr>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                    </tr>
                    <tr>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                        <td>----</td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>
   <div class="showstyle">
       <a id="otherInfo" onclick="showdiv_a('other','otherInfo')">其他信息</a>
       <div class="baset-topbtn">
           <button class="babtn babtn-save" onclick="saveOtherInfo()">保存</button>
       </div>
   </div>
    <div class="none" id="other">
        <div class="page-allinfo">
            <div class="clearfix padding10" style="width:auto;">
                <form id="visitOtherInfo">
                    <input type="hidden" name="id" id="patId">
                <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab">
                    <tr>
                        <td class="width_5">损伤、中毒的外部原因：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                        <td class="width_4">疾病编码：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                        <td class="width_lasttd"></td>
                    </tr>
                    <tr>
                        <td  class="width_5">病理诊断：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                        <td  class="width_5" style="padding-top:10px;">疾病编码：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                        <td class="width_5">病理号：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="pathologyNo"></span></td>
                    <tr/>
                    <tr>
                        <td class="width_5">药物过敏：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                        <td class="width_5">过敏药物：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="alergyDrugs"></span></td>
                        <td class="width_5">死亡患者尸检：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="autopsyIndicator"></span></td>
                    <tr/>
                    <tr>
                        <td class="width_5">ABO血型：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="bloodType"></span></td>
                        <td class="width_5">Rh血型：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="bloodTypeRh"></span></td>
                    <tr/>
                    <tr>
                        <td class="width_5">科主任：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="director"></span></td>
                        <td class="width_5">主任(副主任)医师：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="chiefDoctor"></span></td>
                        <td class="width_5">主治医师：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="attendingDoctor"></span></td>
                        <td class="width_5" >住院医师：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="doctorInCharge"></span></td>
                    <tr/>
                    <tr>
                        <td class="width_5">责任护士：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="dutyNurse"></span></td>
                        <td class="width_5">进修医师：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="advancedStudiesDoctor"></span></td>
                        <td class="width_5">实习医师：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="practiceDoctor"></span></td>
                        <td  class="width_5" >编码员：</td>
                        <td><span ><input   class="easyui-validatebox inpborder"></span></td>
                    <tr/>
                    <tr>
                        <td class="width_5">病案质量：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="mrQuality"></span></td>
                        <td class="width_5"  >质控医师：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="doctorOfControlQuality"></span></td>
                        <td class="width_5">质控护士：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="nurseOfControlQuality"></span></td>
                        <td  class="width_5">质控日期：</td>
                        <td><span ><input   class="easyui-datebox inpborder" name="dateOfControlQuality"></span></td>
                    </tr>
                    <tr>
                        <td class="width_5">离院方式：</td>
                        <td><span ><input   class="easyui-combobox" name="dischargeDisposition" id="discharge"></span></td>
                        <td class="width_5">是否有出院31天内再住院计划：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="plan31Admission"></span></td>
                        <td class="width_5">目的：</td>
                        <td><span ><input   class="easyui-validatebox inpborder" name="reason31Admission"></span></td>
                    <tr/>
                    <tr>
                        <td  class="width_12" style="padding-top:10px;">颅脑损伤患者昏迷时间：</td>
                    <td> 入院前<input  class="easyui-validatebox inpborder" name="" style="width:60px;">天</td>
                    <td><input  class="easyui-validatebox inpborder" style="width:60px;">小时</td>
                    <td><input  class="easyui-validatebox inpborder" style="width:60px;">分钟</td>

                    <tr/>
                   <tr>
                       <td class="width_12" style="padding-top:10px;"></td>
                       <td> 入院后<input  class="easyui-validatebox inpborder" style="width:60px;">天</td>
                       <td><input  class="easyui-validatebox inpborder" style="width:60px;">小时</td>
                       <td><input  class="easyui-validatebox inpborder" style="width:60px;">分钟</td>
                   </tr>

                </table>
                </form>
            </div>
        </div>
    </div>
    <div class="showstyle">
        <a id="showtext2" onclick="showdiv_a('contentid2','showtext2')">收费信息</a>
        <!--<div class="baset-topbtn">
            <button class="babtn babtn-save">保存</button>
        </div>-->
    </div>
    <div class="none" id="contentid2">
        <div class="page-allinfo">
            <div class="clearfix padding10" style="width:auto;">
                <form id="inpCosts">
                <table cellspacing="0" cellpadding="0" border="0" width="100%" class="baind-tab baind-tab-mon">
                    <tr>
                        <td>住院费用总计（元）：</td>
                        <td><input  class="easyui-validatebox inpborder" style="width:150px;"></td>
                    </tr>
                    <tr>
                        <td>1、综合医疗服务类：</td>
                        <td>(1)一般医疗服务费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="generalMedicCosts">(2)一般治疗操作费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="generalTreatOperCosts"></td>
                    </tr>
                    <tr>
                        <td></td>
                        <td>(3)护理费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="nursingCosts">(4)其他费用：<input  class="easyui-validatebox inpborder" style="width:150px;" name="otherCostsMedicServ"></td>
                    </tr>
                    <tr>
                        <td>2、诊断类：</td>
                        <td>(5)病理诊断费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="pathologicalDiagCosts">(6)实验室诊断费<input  class="easyui-validatebox inpborder" style="width:150px;" name="laboratoryDiagCosts"></td>
                    </tr>
                    <tr>
                        <td></td>
                        <td>(7)影像学诊断费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="imagingDiagCosts">(8)临床诊断项目费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="clinicalDiagCosts"></td>
                    </tr>
                    <tr>
                        <td>3、治疗类：</td>
                        <td>(9)非手术治疗项目费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="nonSurgicalTreatCosts">（临床物理治疗费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="llinicalPhysicalCosts">）</td>
                    </tr>
                    <tr>
                        <td></td>
                        <td>(10)手术治疗费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="operationMedCosts">（麻醉费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="anesthesiaCosts">手术费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="operationCosts">）</td>
                    </tr>
                    <tr>
                        <td>4、康复类：</td>
                        <td>(11)康复费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="rehabilitationCosts"></td>
                    </tr>
                    <tr>
                        <td>5、中医类：</td>
                        <td>(12)中医治疗费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="chinaMedTreatCosts"></td>
                    </tr>
                    <tr>
                        <td>6、西医类：</td>
                        <td>(13)西药费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="westMedicCosts">（抗菌药物费用：<input  class="easyui-validatebox inpborder" style="width:150px;" name="antimicrobialAgentsCOsts">）</td>
                    </tr>
                    <tr>
                        <td>7、中药类：</td>
                        <td>(14)中成药费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="chinaAgentCosts">(15)中草药费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="chinaHerbalCosts"></td>
                    </tr>
                    <tr>
                        <td>8、血液和血液制品类：</td>
                        <td>(16)血费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="bloodCosts">(17)白蛋白类制品费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="albuminCosts"></td>
                    </tr>
                    <tr>
                        <td></td>
                        <td>(18)球蛋白类制品费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="globulinCosts">(19)凝血因子类制品费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="clottingFactorCosts"></td>
                    </tr>
                    <tr>
                        <td></td>
                        <td>(20)细胞因子类制品费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="cytokinesCosts"></td>
                    </tr>
                    <tr>
                        <td>9、耗材类：</td>
                        <td>(21)检查用一次性医用材料费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="disposableMaterExamCosts">(22)治疗用一次性医用材料费；<input  class="easyui-validatebox inpborder" style="width:150px;" name="disposableMaterTreatCosts"></td>
                    </tr>
                    <tr>
                        <td></td>
                        <td>(23)手术用一次性医用材料费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="disposableMaterOpertCosts"></td>
                    </tr>
                    <tr>
                        <td>10、其他类：</td>
                        <td>(24)其他费：<input  class="easyui-validatebox inpborder" style="width:150px;" name="otherCosts"></td>
                    </tr>
                    <tr>
                        <td colspan="2" class="tablast-td"></td>
                    </tr>

                </table>
                </form>
            </div>
       </div>
    </div>
</div>
</body>
</html>                                                                                                                                                                                                                                                                                                        